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A Acanthosis Nigricans, 139 Acquired Ichthyosis, 53, 126, 127, 159 Acute

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Index A Anti-EJ, 213, 214, 216 Acanthosis nigricans, 139 Anti-Ferc, 217 Acquired ichthyosis, 53, 126, 127, 159 Antigliadin antibodies, 336 Acute interstitial pneumonia (AIP), 79, 81 Antihistamines, 324 Adenocarcinoma, 115, 116, 151, 173 Anti-histidyl-tRNA-synthetase antibody Adenosine triphosphate (ATP), 229 (Anti-Jo-1), 6, 14, 140, 166, 183, Adhesion molecules, 225–226 213–216 Adrenal gland carcinoma, 115 Anti-histone antibodies (AHA), 174, 217 Age, 30–32, 157–159 Anti-Jo-1 antibody syndrome, 34, 129 Alanine aminotransferase (ALT, ALAT), 16, Anti-Ki-67 antibody, 247 128, 205, 207, 255 Anti-KJ antibodies, 216–217 Alanyl-tRNA synthetase, 216 Anti-KS, 82 Aldolase, 14, 16, 128, 129, 205, 207, 255, 257 Anti-Ku antibodies, 163, 165, 217 Aledronate, 325 Anti-Mas, 217 Algorithm, 256, 259 Anti-Mi-2 Allergic contact dermatitis, 261 antibody syndrome, 11, 129, 215 Alopecia, 62, 199, 290 antibodies, 6, 15, 129, 142, 212 Aluminum hydroxide, 325, 326 Anti-Myo 22/25 antibodies, 217 Alzheimer’s disease-related proteins, 190 Anti-Myosin scintigraphy, 230 Aminoacyl-tRNA synthetases, 151, 166, 182, Antineoplastic agents, 172 212, 215 Antineoplastic medicines, 169 Aminoquinolone antimalarials, 309–310, 323 Antinuclear antibody (ANA), 1, 141, 152, 171, Amyloid, 188–190 172, 174, 213, 217 Amyopathic DM, 6, 9, 29–30, 32–33, 36, 104, Anti-OJ, 213–214, 216 116, 117, 147–153 Anti-p155, 214–215 Amyotrophic lateral sclerosis, 263 Antiphospholipid syndrome (APS), 127, Antisynthetase syndrome, 11, 33–34, 81 130, 219 Anaphylaxi, 316 Anti-PL-7 antibody, 82, 214 Anasarca, 52, 137 Anti-PM-Scl antibodies, 33, 163–165, 216 Angioedema, 195 Anti-Ro (SS-A) antibodies, 166, 217 Angiokeratoma, 139 Anti-signal recognition particle (Anti-SRP), Animal models, 285–290 213–215, 218 Annexin XI, 214 antibodies, 74, 184 Anorexia, 136, 137 syndrome, 11, 130, 183, 215 Anti ADAM 10, 82 Anti-7SL RNA antibodies, 184 Anti-CADM-140 antibodies, 214 Anti-SS-A antibodies, 217 Anticardiolipin (aCl) antibodies, 219 Anti-SS-B antibodies, 217 Anticytokines, 316–318 Antisynthetase autoantibodies, 82–83 345 346 Index Antisynthetase syndrome, 6, 49, 151, 166, Canine dermatomyositis, 289, 290 182, 213–216, 277 Capillary microscopy, 137 Anti-TNF therapy, 316 Carbonic anhydrase, 16 Anti-U1RNP antibodies, 163, 216, 219 isoenzyme III, 208 Anti-U2RNP antibodies, 163, 216 Carcinoid myopathy, 200 Apolipoprotein E gene, 190 Carcinoma, 112, 115–117 Apoptosis, 172, 234, 244–245, 286, 288 Cardiac arrhythmia, 193–194 Apoptotic keratinocytes, 235 Cardiac murmurs, 141 Arthralgias, 14, 66, 69, 127, 128 Cardiac transplantation, 193–194 Arthritis, 14, 66, 69–70, 127, 128, 140, Cardiomyopathy, 184 150–151, 215 Carpal tunnel syndrome, 182 Arthropathy, 69 Caspase-3, 245 Asparginyl-tRNA synthetase, 82, 214, 216 C5b-9 MAC, 286 Aspartate aminotransferase (AST, ASAT), 16, C3bNEO, 315, 316 128, 205, 207, 255 CD40, 245, 247 Aspiration, 90, 256 CD59, 279, 280 Aspiration pneumonia, 83–84, 128 CD20+ B cells, 244, 245, 287 Asymmetrical painless weakness, 188 CD59 glycolipid anchor, 280 Atopic dermatitis, 261 CD45 RO+ Atorvastatin, 170–171 lymphocytes, 247 Atrophicans vasculare, 262 memory T cells, 244 Atrophic erythema, 172 CD3+ T cells, 247, 248, 287 Atrophy, 45–46, 66–67, 243–246 CD4+ T cells, 196, 244, 247 Autologous stem cell transplant, 333 CD8+ T cells, 142, 227, 244, 245 Axonal neuropathy, 318 Celiac disease, 336 Azathioprine, 85, 303–305, 307, 308, 319 Cell-mediated immunity, 140, 248, 286 Cellulite-like massive mucinosis, 53 B Centripetal linear/flagellate erythema Banker variant, 137 (Zebra-like DM), 21, 47 Basal membrane zone, 247 Chemokines, 247–248, 280 Basic fibroblast growth factor (bFGF), 226 Childhood scleromyositis, 164 B-cell lymphoma, 172 Chlorambucil, 303, 308, 319 Beta-amyloid, 189–190 Chloroquine, 309 precursor protein, 190 Chondrodermatitis nodularis Bleomycin, 47 helices, 126, 127 Borrelia burgdorferi, 181, 184, 272, 285 “Classic” dermatomyositis in adults, 82, 305, Breast implants, 270 306, 332, 341, 342 Bronchiolitis obliterans organizing pneumonia Climate, 34, 269, 270 (BOOP), 79–81, 85 Colchicine, 325, 326 Bronchoalveolar lavage fluids (BALF), 83 Colloidal bodies, 173, 247 Brunsting-Perry type, 137 Common reactivity pattern, 174 Bullous lesions, 18, 21, 51, 159 Community-acquired pneumonia, 85 Bullous pemphigoid, 51, 126 Complement, 245–247 Computed tomography (CT), 79, 81, 85 C Congestive heart failure, 73 CA 125, 256 Conjunctival edema, 93 Calcification, 62, 107, 108, 325–327 Connective tissue diseases (CTD), 163 Calcineurin, 317 Contracture, 67 Calcinosis, 5, 17–18, 20, 22, 44, 51–52, 107, Contrast-enhanced ultrasound, 230 108, 135, 137–141, 182 Corticosteroids, 97–98 universalis, 107, 108, 150, 326 Corticosteroid-sparing agent, 302 Calcium channel blockers, 324, 326 Coxsackie B virus, 181, 270, 272 Calcium phosphate, 108 Crackling rales, 80 Callosity feet, 47, 50 C-reactive protein, 14, 23, 158–159, 225–226 Cancer, 111–118 Creatine, 205–207, 225, 227, 229 Index 347 Creatin kinase (CK) 16, 67, 157, 205 Dermatomyositis sine myositis, 6, 9, 147–148, CK/AST ratio, 208 152, 172 CK isoenzymes, 205 γ-DNA polymerase, 174 CK-MB, 205–208 DNA synthesis, 173 CKMB/total CK ratio, 227 Doppler, 230 CK-MM, 205 Double immunodiffusion method, 214 Cryptogenic fibrosing alveolitis, 82 d-penicillamine, 165, 169–170, 181 CTGF growth factors, 200 Drug-induced amyopathic DM, 152 Cutaneous assessment tool, 22 Drug-induced dermatomyositis (DI-DM), 10, Cutaneous atrophy, 172 11, 116, 117, 169 Cutaneous biopsy, 195, 226 Drug-induced eosinophilic polymyositis, 196 Cutaneous disease indexes, 22 Drug-induced polymyositis, 172 Cutaneous lesions, 43, 47, 49–50, 53 DSSI. See Dermatomyositis skin severity Cutaneous mucinosis, 125 index Cutaneous necrosis, 21, 53, 157–158 Duodenal perforation, 90 Cutaneous photosensitivity, 22 Dyschromatopsia, 94 Cutaneous T-cell lymphoma (mycosis Dysphagia, 62–63, 65–67, 89–90, 128, 140, fungoides), 262 256, 336 Cutaneous ulcers, 137 Dysphasia, 21 Cutaneous vasculitis, 18, 20, 44, 50, 125, 128 Dysphonia, 66, 89 Cuticular hypertophy, 19, 47 Dyspnea, 139, 140, 151 Cyclophosphamide, 117, 152, 170–173, 303, Dystrophic calcification, 107, 108, 150 306–307, 314, 318, 319, 325 Dystrophin, 196 Cyclophosphamide-induced pulmonary disease, 83 E Cyclosporin-associated encephalopathy, 102 Eculizumab, 318 Cyclosporine A, 303–306, 316, 318 Edema, 136, 137 Cysticerca, 181 Edema Quincke, 45 Cytochrome oxidase, 244 Edematous gingivitis, 61–62 Cytokine-encoding genes, 305 Electrocardiogarphic abnormalities, 141 receptors, 227 Electromyography (EMG), 16, 101, 135, 136, Cytokines, 197, 248 147–148, 152, 227, 255 Elschnig’s spots, 93 D Emollients, 324 Dapsone, 318–319 Encephalopathy, 102 Decreased intestinal motility, 89 Endomysial inflammation, 182 Degos disease, 126 Endomysium, 189, 195 Deposits of membrane attack complex, 22 Eosinophilia, 195–196, 263–264 Dermatitis herpetiformis, 51, 126 Eosinophilia-myalgia syndrome, 196, Dermatomyositis-like eruption, 152, 172 199–200, 264 Dermatomyositis skin severity index Eosinophilic cationic protein, 196 (DSSI), 22 fasciitis, 195–196, 199–200 Dermatosclerosis, 53 inclusions, 189 Diabetes mellitus, 139 myositis/perimyositis (EM/P), 10–11, 195 Diclofenac, 170–171 Eosinophilic polymyositis, 196–197 Diffuse alveolar damage (DAD), 79–81, 85 Epidermal necrosis, 18, 21 Diffuse alveolitis, 80 Epimysium, 195 Diffusion capacity, 81 Epstein-Barr virus, 173 Diltiazem, 324–326 Erosions, 46, 51, 53, 61–62 Diphosphonates, 325 Erythrocyte sedimentation rate (ESR), 14, Diplopia, 93, 193 23, 225 Distal dysphagia, 89 Erythroderma, 18, 21, 44, 46, 49, 125 Distal weakness, 189 Erythrodermic dermatomyositis, 21 Dermatomyositis in childhood, 159 Eschares, 20, 47, 50 Dermatomyositis like syndrome c, 171 E-selectin, 225–226, 281 348 Index Esophageal dysmotility, 89–90 Glycoaminoglycans, 200 gastric reflux, 140 Glycyl-tRNA synthetase, 216 hypomotility, 163, 165 Gottron’s papules, 10, 13–15, 18–19, 44, 47, motility, 67 136, 149, 164, 166, 172, 247–248 reflux, 89–90 Gottron’s sign, 14–15, 18–19, 44, 47, 125, Etanercept, 316, 317 137, 149–150, 152, 172 Ethnic distribution, 30, 32 Gower’s sign, 66 Etoposide, 152, 172–173 Graft-versus-host disease (GVHD), 262 Excoriations, 51 reaction, 246 Exfoliative dermatitis, 46, 319 Granulomatous eosinophilic polymyositis, 196 Exophthalmus, 193 myositis, 10–11 Extracorporeal photochemotherapy, 332 Guillain-Barré syndrome, 263 Extraocular muscles, 193–194 Ezitimibine, 171 H Haemophilus influenzae, 285 F Handheld myometer, 231 Facial-fold erythema, 45 Hashimoto thyroiditis, 165 Factor VIII-related antigen, 23, 225 Helicase protein complex, 212 Familial dermatomyositis, 32 Heliotrope eruption, 10 Fasciitis, 53 Heliotrope eyelid eruption, 261 Fatigue, 151 rash, 13–15, 18, 43–44, 46, 52, 125, 130 Ferritin, 81, 183 Hemolytic anemia, 131 Fetal antigens, 104 Hemophagocytic syndrome, 127, 129 Fetal loss, 104, 105 Hemorrhagic infarcts, 19 Fetal microchimerism, 214, 289 Hepatitis B virus, 181 Fetal mortality, 103 Hepatocellular carcinoma (HCC), 116, 117, Fever, 135–137 141, 158, 159 Fibrates, 171–172 HEp-2 cells, 213, 217 Fibromyalgia, 66, 151, 270 Herbal supplement, 174 Fibrosis, 73–74 Hereditary inclusion body myopathy, 188 Flagellate erythema, 47, 125 High-dose intravenous immunoglobulins Fludarabine, 308 (IVIG), 297, 306, 307, 314–316 Fluvastatin, 171 High-frequency ultrasound, 135, 230 Focal nodular myositis, 11 High-resolution computed tomography Follicular atrophy, 290 (HRCT), 81, 85 Follicular hyperkeratosis (Type wong), 21, 44, Hirsutism, 139 47–49 Histidyl-tRNA
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  • Myositis 101

    Myositis 101

    MYOSITIS 101 Your guide to understanding myositis Patients who are informed, who seek out other patients, and who develop helpful ways of communicating with their doctors have better outcomes. Because the disease is so rare, TMA seeks to provide as much information as possible to myositis patients so they can understand the challenges of their disease as well as the options for treating it. The opinions expressed in this publication are not necessarily those of The Myositis Association. We do not endorse any product or treatment we report. We ask that you always check any treatment with your physician. Copyright 2012 by TMA, Inc. TABLE OF CONTENTS contents Myositis basics ...........................................................1 Diagnosis ....................................................................5 Blood tests .............................................................. 11 Common questions ................................................. 15 Treatment ................................................................ 19 Disease management.............................................. 25 Be an informed patient ............................................ 29 Glossary of terms .................................................... 33 1 MYOSITIS BASICS “Myositis” means general inflammation or swelling of the muscle. There are many causes: infection, muscle injury from medications, inherited diseases, disorders of electrolyte levels, and thyroid disease. Exercise can cause temporary muscle inflammation that improves after rest. myositis